Sexual Health Implications in Severe Mental Illness
Summary
Sexual health is an integral component of overall wellbeing yet remains under‐recognised in people living with severe mental illness (SMI), such as schizophrenia and bipolar disorder. Symptoms of psychosis and mood disturbance can diminish sexual desire and performance, while antipsychotic and mood‐stabilising medications frequently induce sexual dysfunction through effects on dopamine, serotonin and prolactin pathways. Stigma, cognitive impairment and negative self‐image further hinder intimate relationships, contributing to social isolation and reduced quality of life. Barriers within clinical practice include lack of clinician training, discomfort in discussing sexual needs and fragmented services that separate mental healthcare from sexual and reproductive health provision. Conversely, addressing sexual health openly can strengthen the therapeutic alliance, improve adherence to treatment and enhance psychosocial recovery. Internationally, there is growing recognition of the need for integrated screening programmes, patient education on medication side‐effects, and collaborative care pathways that encompass psychoeducation, peer support and referral to specialist sexual health services. Tailoring interventions to cultural contexts and ensuring privacy and choice remain crucial in promoting sexual wellbeing among individuals with SMI.
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Sexual Health Implications in Severe Mental Illness publication trend
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Technical terms
Sexual dysfunction: Impairment in sexual desire, arousal, orgasm or satisfaction that may arise from psychiatric symptoms or treatment side effects.
Severe mental illness: A category of mental disorders, including schizophrenia and bipolar disorder, characterised by chronicity, significant functional impairment and high risk of morbidity.
Hyperprolactinaemia: Elevated serum prolactin levels often induced by antipsychotic medication, which can cause sexual dysfunction and menstrual irregularities.
Therapeutic alliance: The collaborative and trusting relationship between clinician and patient that underpins effective mental healthcare and encourages disclosure of sensitive issues.
Phenomenological study: A qualitative research approach that explores individuals’ lived experiences and perceptions to uncover the essence of a particular phenomenon.
References
- The atypical antipsychotics and sexual dysfunction: a pharmacovigilance-pharmacodynamic study. Frontiers in Pharmacology (2024).
- Sexual needs of people with schizophrenia: a descriptive phenomenological study. BMC Psychiatry (2023).
- Barriers and facilitators to accessing sexual and reproductive health services for people with severe mental illness: a systematic review. Social Psychiatry and Psychiatric Epidemiology (2025).
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